Department of Medicine III and Center for Healthy Aging, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
Curr Osteoporos Rep. 2022 Jun;20(3):194-201. doi: 10.1007/s11914-022-00731-0. Epub 2022 Jun 8.
The incidence of diabetes is increasing worldwide. Diabetes mellitus is characterized by hyperglycemia, which in the long-term damages the function of many organs including the eyes, the vasculature, the nervous system, and the kidneys, thereby imposing an important cause of morbidity for affected individuals. More recently, increased bone fragility was also noted in patients with diabetes. While patients with type 1 diabetes mellitus (T1DM) have low bone mass and a 6-fold risk for hip fractures, patients with type 2 diabetes mellitus (T2DM) have an increased bone mass, yet still display a 2-fold elevated risk for hip fractures. Although the underlying mechanisms are just beginning to be unraveled, it is clear that diagnostic tools are lacking to identify patients at risk for fracture, especially in the case of T2DM, in which classical tools to diagnose osteoporosis such as dual X-ray absorptiometry have limitations. Thus, new biomarkers are urgently needed to help identify patients with diabetes who are at risk to fracture.
Previously, microRNAs have received great attention not only for being involved in the pathogenesis of various chronic diseases, including osteoporosis, but also for their value as biomarkers. Here, we summarize the current knowledge on microRNAs and their role in diabetic bone disease and highlight recent studies on miRNAs as biomarkers to predict bone fragility in T1DM and T2DM. Finally, we discuss future directions and challenges for their use as prognostic markers.
全球范围内糖尿病的发病率正在上升。糖尿病的特征是高血糖,长期高血糖会损害包括眼睛、血管、神经系统和肾脏在内的许多器官的功能,从而成为受影响个体发病的重要原因。最近,人们还注意到糖尿病患者的骨脆性增加。虽然 1 型糖尿病(T1DM)患者的骨量低,髋部骨折风险增加 6 倍,但 2 型糖尿病(T2DM)患者的骨量增加,髋部骨折风险仍增加 2 倍。尽管潜在机制才刚刚开始被揭示,但缺乏用于识别骨折风险患者的诊断工具,尤其是在 T2DM 中,用于诊断骨质疏松症的经典工具如双能 X 线吸收法(DXA)存在局限性。因此,迫切需要新的生物标志物来帮助识别有骨折风险的糖尿病患者。
先前,microRNAs 不仅因其参与各种慢性疾病(包括骨质疏松症)的发病机制而受到关注,而且因其作为生物标志物的价值而受到关注。在这里,我们总结了 microRNAs 及其在糖尿病性骨病中的作用的最新知识,并重点介绍了 microRNAs 作为生物标志物预测 T1DM 和 T2DM 脆性骨折的最新研究。最后,我们讨论了将其用作预后标志物的未来方向和挑战。